Within the range of psychotic symptoms, negative symptomatology is the one that presents the least effective treatments. Depressive symptoms share characteristics with this symptomatology, making it difficult to distinguish between the two (Edwards et al. Psychol.Med. 2019; 1-13). In daily practice, antidepressants are used to treat the negative symptoms of psychosis, due to the absence of therapeutic alternatives.

The aim of this work is to analyse the correlation between these symptomatic groups, comparing the effectiveness of treatment with antidepressants during a three-month follow-up.

Longitudinal and prospective clinical trial on a sample of 127 patients (95 men, 32 women) with dual psychosis (85 with schizophrenia, 42 with schizoaffective disorder), recruited from community or hospital facilities of the Hospital Provincial of Castellon. The mean age was 38.5 years. Antidepressant prescription was analysed at 4 different times, each month during follow-up, with PANSS-N for negative symptoms and MADRS and CDSS for depressive symptomatology.

Psychometric comparisons were made between the intervention group (16 patients with prescribed antidepressants, in therapeutic doses during the three months) and the control group (111 patients).

Regarding the correlation between the 3 scales, we observed that at T0 there is no significant correlation, while at T1, T2 and T3 this correlation is significant (p<0.01), as the scores improve. A progressive increase in Pearson’s coefficient (PCC) is observed between T1 and T3, emphasizing a higher correlation between MADRS and CDSS (PCC of 0.920 at T3) with respect to PANSS-N and the other two questionnaires (PCC of 0.587 and 0.619 at T3, respectively).

Comparing the means between the scales, there is a significant decrease in MADRS between T0 and T3 (61.8% decrease from baseline, F: 4.49, p<0.05), as well as in CDSS (-68.7%, F: 4.53, p<0.05). In PANSS-N there are no significant differences (F: 0.57, p: 0.45), despite a relative decrease of 51.9%.

Considering clozapine prescription, there is a significant decrease in MADRS and CDSS during the first month, with no differences in PANSS-N throughout the evolution.

The reduction obtained in the MADRS and CDSS scales can be associated with the prescription of antidepressants, as opposite to the reduction obtained in PANSS-N. This implies that antidepressants do not influence the reduction in negative symptoms, reflecting the clinical impression that the two entities are distinct (despite areas of overlap).

The analysis using clozapine treatment reinforces the existence of a different idiosyncrasy between symptomatic groups. This can be explained at the neurobiological level by the different mechanisms of action involved (monoamine depletion vs. dopaminergic blockade), but keeps the debate open as to how they can be differentiated and treated in clinical practice.

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Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia and is clinically characterised by progressive behavioural changes, executive dysfunction and language difficulties. FTD is often confused with Alzheimer’s disease and other psychiatric disorders. Clinical features of FTD include personality changes, agitation, loss of inhibition, apathy, social withdrawal and impulsivity. In some cases, the disease is accompanied by mood or psychotic symptoms, resulting in the diagnosis of an additional psychiatric disorder. (Gliebus G.(2014). SAGE open medical case reports,2, 2050313X13519977.). This article presents the case of a middle-aged woman who was diagnosed with an anxiety spectrum disorder before developing and being diagnosed with FTD.

A 57-years-old right handed female with previous history of anxiety disorder admitted to psychiatry clinic with restlessness, decreased sleep, and complain of constant non-purpose walking. Physical examination revealed bradymimia and grabellar reflex. Additionally in her psychiatric evaluation she had short-term memory impairment, disinhibition and verbal perseverations. She had been given multiple combinations of medications by outpatient providers and her restlessness only increased. At the time of admission she was taking mirtazapine,olanzapine and clonazepam. The initial impression was that she had akathisia, and her medications were tapered. She was then started on propanolol and lorazepam. After several days her symptoms had not changed.

In routine biochemical and hematological tests, electroencephalogram (EEG) were within normal limits. 18F-FDG PET/MRI revealed hypometabolism in the bilateral temporal-frontoparietal region, more pronounced in the frontal region which is consistent with FTD.

Trazodone was started to control behavioural symptoms and the dose was gradually increased to 150 mg/day. The dose of propranolol was increased to 80 mg/day, and lorazepam was tapered and discontinued. During the follow up with this treatment, there was an improvement in her restlessness and anxiety symptoms, but her memory problems were persistent.

Frontotemporal dementia may overlap and be confused with other psychiatric disorders. Therefore, a comprehensive history, physical and neurological examination are required to differentiate each clinical entity (Khan I, De Jesus O. (2023).Frontotemporal Lobe Dementia. In: StatPearls ). Additionally, the use of functional neuroimaging, such as 18F-FDG PET/MRI, enables the different distribution of pathology in dementing disorders to be highlighted, as can be seen in our case. This case report highlights the importance of re-evaluating patients with psychiatric diseases, especially when symptoms are resistant to treatment.

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Work-related mental health issues are becoming increasingly prevalent, particularly in professions involving direct communication and care, such as healthcare. Primary Health Care (PHC) plays a critical role in prevention, health promotion, and the management of emergency situations. The mental and emotional well-being of healthcare professionals in PHC is essential for maintaining high levels of performance and work effectiveness. However, there is limited research on the psychosocial conditions of healthcare staff in PHC settings, particularly regarding anxiety, stress, depression, and psychological distress.

The objective of this study is to evaluate the prevalence of anxiety, stress, depression, and psychological distress among medical and nursing staff working in primary healthcare units in Peloponnese. Additionally, the study aims to examine the associations between these mental health indicators and various individual and professional characteristics, such as age, gender, and professional role.

An online survey was conducted to gather data from a final sample of 103 healthcare professionals. A questionnaire was constructed ad hoc and comprised two well-established measurement tools. The Depression, Anxiety, and Stress Scale (DASS-21) was employed to assess anxiety, stress, and depression, while the K6+ was used as a self-report measure to evaluate psychological distress.

The results demonstrated that the participants exhibited generally low levels of anxiety, stress, and depression. As indicated by the DASS-21 scale, approximately 75% of respondents reported minimal to no anxiety, with only 7.8% reporting severe anxiety. Similarly, 75% of respondents indicated minimal to no stress, with only 4% reporting severe stress. Regarding depressive symptoms, 76% of participants exhibited minimal to no depressive symptoms, while only 4% demonstrated severe depressive symptoms. However, approximately 20% of the sample exhibited signs of psychological distress, which may indicate a significant mental health concern. Significant correlations were found through statistical analysis: older employees exhibited lower levels of anxiety, while nursing staff demonstrated higher levels of anxiety compared to medical staff. Additionally, women reported higher anxiety levels than their male colleagues.

In conclusion, while anxiety, stress, and depression levels are generally low among healthcare professionals, a notable portion of the workforce is at risk of serious psychological distress. These findings indicate the need for targeted mental health interventions, particularly for younger staff, nurses, and female employees, to ensure the well-being of healthcare professionals and maintain the efficacy of primary healthcare services.

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Body dysmorphic disorder is a diagnostic entity within the somatoform disorders of the obsessive-compulsive spectrum according to the DSM-V. Its prevalence is between 0.7% and 2.5%, being more frequent in men and usually beginning in adolescence or early adulthood. Its central symptom is cognitive distortions regarding appearance, with concern about imaginary physical defects, slight or even invisible to others and in some cases close to a delusional condition.

To delve deeper into the clinical aspects and nosological conditions through the description of a clinical case.

This is a 16-year-old patient who was admitted three times to the Acute Psychiatric Unit of the Puerta de Hierro Hospital due to behavioral disorders in the context of dysmorphophobia with intense concern about the shape of his nose. The patient gradually abandoned his daily routines, stopped attending classes at school and isolated himself from his social circle.

He is the youngest of two sisters. He lives with his parents and sister. He had good academic results until the time of diagnosis.

The patient’s concern about his nose began at about age 15, coinciding with the diagnosis of leukemia of his mother, who was undergoing chemotherapy treatment. The patient reports that the symptoms have increased until causing significant functional limitation.

He says that his nose is very large and he doesn’t allow anyone to see it. He leaves the house wearing a mask, performs rituals of checking it for hours in front of the mirror and has even manipulated his nose with objects to try to deform it. He appears to have a delusional component with significant emotional and behavioural repercussions.

Several pharmacological treatments were started, including SSRIs (sertraline) and various antipsychotics (risperidone, pimozide and olanzapine), with little response in all cases. Psychotherapeutic treatment was carried out in a day hospital for adolescents, but this was also unsuccessful. Finally, he was involuntarily transferred to a Medium Stay Unit given the significant impact of the symptoms on his life, showing progressive improvement after several months of treatment.

The nosology of TDC has evolved: the DSM IV specified a delusional variant within the psychotic spectrum and a non-delusional one within the somatoform spectrum. The DSM V integrates it within the obsessive-compulsive spectrum. In order to assess a correct treatment, a continuum could be established between TDC and eating disorders. Both present similar symptoms: dissatisfaction and distortion with body image, need for continuous checking and concern about imperfections in perceived appearance. Given the chronicity of TDC and the tendency to abandon treatment in the first months, long-term follow-up by a multidisciplinary team is necessary, as well as psychoeducation and the establishment of a solid therapeutic alliance.

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Resilience, the ability to adapt and thrive amid adversity, is particularly prominent in Tunisian women, who are recognized for their strength and adaptability despite societal pressures. Their resilience appears closely linked to cultural heritage, indicating a significant connection between resilience and cultural values. This study explores how cultural values shape the psychological resilience of Tunisian women.

To examine the influence of cultural values on resilience among Tunisian women.

A cross-sectional survey was conducted Tunisian women aged 18 and above, from June to August 2024. Sociodemographic data were gathered, while cultural values were assessed using the Individual Cultural Values Scale (CVScale) and the Centrality of Religion Scale (CRS-5). Resilience was measured with the 25-item Connor-Davidson Resilience Scale (CD-RISC 25).

We collected 695 responses in our survey. Participants had a mean age of 36.72 ± 12.23 years, with 90.9% holding university degrees, 56.5% employed, 49.2% married, and 50.6% with children. The mean resilience score was 68.26 ± 14.09, with 26.3% showing low resilience. Average scores for cultural values were “power distance” (9.13 ± 3.46), “uncertainty avoidance” (20.84 ± 2.95), “masculinity” (9.55 ± 3.99), “collectivism” (21.64 ± 5.07), “long-term orientation” (25.89 ± 2.94), and “centrality of religion” (3.95 ± 0.77).

Resilience correlated positively with “uncertainty avoidance” (p < 10⁻³, r = 0.145), “collectivism” (p < 10⁻³, r = 0.208), “long-term orientation” (p < 10⁻³, r = 0.267), and “centrality of religion” (p < 10⁻³, r = 0.186). Conversely, resilience was negatively correlated with “power distance” (p < 10⁻³, r = -0.104), and no significant correlation was observed with masculinity.

The findings reveal that cultural values significantly shape resilience in Tunisian women. Higher resilience was associated with uncertainty avoidance, collectivism, long-term orientation, and religious centrality, while power distance negatively impacted resilience. This emphasizes the need to incorporate cultural dimensions when designing initiatives to support resilience among women in Tunisia.

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Neuromodulation technologies became the safe and effective alternative to treat psychiatric and neurological disorders. The current evidence from the up-to-date state in vagus nerve stimulation application in studies of emotional state modulation demonstrates a strong impact of vagus stimulation on the state of patients with a range of disorders. The normalizing effect of vagus nerve stimulation on abnormal sympathetic nerve activity may explain the beneficial effect on burnout, which is thought to be a manifestation of decreased vagus-mediated heart rate variability (HRV) under everyday stress.

Considering all of the above, we aimed to explore the influence of a novel VNS stimulation protocol on emotional state, as well as highlighting specific features of the activation-related neurodynamics and the effects on HRV time, frequency and non-linear metrics.

11 right-handed male volunteers aged 18-22 years participated in the 1st (EEG) study (6 persons-taVNS group and 5-SHAM) and 62 healthy volunteers 18-49 years old were recruited for 2nd (HRV) study (26-VNS group and 22–Sham). We used the combination of pleasant meditative classical music and a slow bi-polar wave of electrical non-invasive transcutaneous stimulation of auricular area (BrainPatch platform for non-invasive stimulation). Vagus nerve stimulation was arranged as a 4-day course. Psychological testing (State Anxiety, STAI; psychological stress level, PSM-25; severity of emotional burnout, MBI; depression, IDS) was carried out.

Non-invasive stimulation was rated by the participants as a positive experience. We detected beneficial changes in the psychoemotional state of the respondents (improvement of mood, reduction of job related stress – emotional burnout). The increase of vagally mediated parameter RMSSD and decrease of LF/HF ratio has reflected the activation of parasympathetic nervous system (PNS) during stimulation. HRV effects of VNS turned out to be short-term, which was manifested in a drop in the value immediately after the stimulation. EEG analysis indicated a long-term effect of VNS. Increased alpha and beta rhythms (generalized growth in the frontal and posterior cortex) and gamma activity (frontal region) after a series of 4 VNS sessions may indicate the improvement of mental processes and creative thinking (attention, information processing and memory storage). Enhanced activation level was mirrored in an increased beta/alpha ratio.

Our data suggests that VNS has a normalizing effect on the psychoemotional state shifting “sympatho-vagal balance” to the functional optimum. EEG data showed the prolonged stimulating effect on the brain processes related to the cognitive functioning while attenuating the stress impacts at the same time.

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Treatment-resistant schizophrenia patients have the worst clinical outcomes and poor quality of life, despite the administration of clozapine. Currently, the definition of resistance is based on treatment response, but evidence differentiating resistance remains unclear. The dysconnectivity theory suggests that disrupted brain interactions contribute to schizophrenia pathology. Advances in functional and structural neuroimaging allow exploration of connectivity patterns that may characterize treatment-resistant schizophrenia.

This study aimed to describe functional and structural connectivity patterns in schizophrenia patients on clozapine.

Patients taking clozapine (CLZ) or other antipsychotic (nCLZ) were recruited from the Hospital of the Medical School of Ribeirão Preto. Healthy controls (HC) were recruited from the Hospital database. Seventy-seven participants were selected: CLZ = 35, nCLZ = 27, and HC = 27. Functional connectivity (FC) was assessed via resting-state functional magnetic resonance imaging (rs-fMRI) and ROI-to-ROI analysis using the CONN toolbox. Structural connectivity was analyzed with diffusion tensor imaging and tractography using TRACULA toolbox. ANOVA and Tukey test were used for three-group comparisons, and the t-tests for two-group comparisons. Functional analysis was performed with a significance threshold of p < 0.05 and false discovery rate (FDR) set to p < 0.01.

Reduced frontotemporal FC and increased FC in the frontal-occipital were common in CLZ and nCLZ compared to HC. An increased FC between sensorimotor and the cerebellum was notable in CLZ compared to HC. Structural findings included increased axial diffusivity (AD) and mean diffusivity (MD) in 8 of 10 tracts in CLZ compared to HC. The corticospinal tract and inferior longitudinal fasciculus exhibited increased AD and MD in CLZ compared to nCLZ. The cingulum angular bundle showed significantly altered diffusion measures in nCLZ: increased AD, MD, and radial diffusivity (RD), and reduced fractional anisotropy (FA).

This study described a widespread functional and structural dysconnectivity in CLZ, characterized by reduced frontotemporal FC and increased frontal-occipital and sensorimotor–cerebellum FC. Altered AD and MD measures in the corticospinal tract and inferior longitudinal fasciculus were observed in the CLZ. Alterations in AD, MD, RD, and FA measures in the cingulum angular bundle, particularly noted in nCLZ, may be associated with antipsychotic administration. Further studies are necessary to establish whether these dysconnectivity patterns consistently characterize these patient groups.

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Ekbom syndrome, also known as delusional parasitosis, is a psychiatric disorder in which the affected person is firmly convinced that their body is infested with parasites, insects, or any other microorganism, despite the lack of medical evidence to support it.

A 56-year-old woman presents to the emergency department, referred by her primary care physician, due to a sensation of worms in her vagina and rectum. She reports that larvae are coming out of her nostrils, ears… and she feels them settling in her kidney. She is accompanied by her husband, who mentions that on some occasions, she has shown him the supposed parasite.

The objectives of this clinical case are to understand whether Ekbom syndrome can be related to any secondary organic pathology, as well as to identify the conditions with which the differential diagnosis should be made, and to determine the most effective treatments.

Examination: Sensory-perceptual disturbances in the form of cenesthetic hallucinations. High levels of anxiety with functional impact on her daily life.

Complementary tests: A referral was made to Internal Medicine to rule out the presence of parasites, and to Neurology for an MRI with contrast, which revealed a white matter lesion in the brainstem. Tests for anti-AQP4 and anti-MOG antibodies were also conducted, and both were negative. After these studies, it was concluded that the criteria for secondary Ekbom syndrome due to organic pathology were not met.

The differential diagnosis should be made with other psychiatric disorders such as schizophrenia, major depression, or substance-induced psychosis. Neurological diseases, such as dementia, multiple sclerosis, or meningoencephalitis, should also be ruled out. Lastly, it is advisable to rule out dermatological conditions, such as scabies.

Treatment was initiated with Risperidone and Alprazolam, with good response and improvement in delusional ideation.

Treatment with atypical antipsychotics is effective for this syndrome, reducing delusional ideas and significantly improving the psychiatric symptoms that accompany the delusion, such as anxiety, depression, and insomnia.

Good collaboration between different medical professionals is essential to rule out associated secondary pathology.

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A multi-site randomized controlled study demonstrated that the community mental health intervention GBV, when combined with standard care in the German healthcare system, led to greater improvements in empowerment, quality of life, and needs-orientation for people living with severe mental illness. However, to gain a comprehensive understanding, it is essential to include service users’ perspectives alongside effectiveness data.

This study aimed to assess the implementation of GBV from the service users’ viewpoint, providing a holistic evaluation of the intervention beyond randomized trial results.

A mixed-methods approach was used to evaluate the service users’ experiences with GBV. Semi-structured interviews were conducted, transcribed, and analysed using thematic content analysis. Additionally, fidelity ratings were collected after 12 months of intervention, based on a scale developed from GBV quality standards, focusing on needs orientation, relationship building, and service availability.

The process evaluation revealed a greater increase in empowerment, subjective quality of life and treatment satisfaction as well as a greater reduction in unmet needs with a subjectively higher perceived manual fidelity. Qualitative interviews supported these findings, emphasizing the critical role of strong relationships with GBV staff, personalized care tailored to individual needs, and adherence to GBV’s quality criteria.

While the effectiveness of GBV has been established, ensuring fidelity to the intervention’s manual is crucial for large-scale implementation. Key factors for success include a focus on relationship building and needs-orientation, ensuring that service delivery aligns with the predefined GBV quality standards.

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Knowledge of the prenatal predictors of postpartum depressive symptoms is of fundamental importance in preventing them.

This study aimed to examine whether first trimester maternal hair cortisol influenced maternal postpartum depressive symptoms.

The women (N = 75) were tested twice: in the first trimester of pregnancy and within three months after delivery. In the first trimester, they had hair samples taken and were examined using a sociodemographic survey and questionnaires: the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale (PSS-10), and the Zimbardo Time Perspective Inventory (ZTPI). After delivery, women completed a survey about the course of delivery and their child’s health, EPDS, PSS-10, and ZTPI.

A multiple hierarchical regression analysis was conducted to identify the predictors of postpartum depressive symptoms. In the first step, presence of maternal chronic illness and birth length were added, since these variables were associated with postpartum stress in our study. In the second step, we added the scores on depressive symptoms (EPDS) and stress (PSS-10) in the first trimester. After including hair cortisol concentration in the third step, depressive symptoms, stress, and hair cortisol concentration in the first trimester turned out to be predictors of postpartum depressive symptoms. The results showed that higher levels of depressive symptoms and stress and a lower level of hair cortisol concentration in the first trimester were associated with higher levels of postpartum depressive symptoms. We conducted mediation analyses to test time perspective as a mediator in the relationship of hair cortisol concentration in the first trimester to postpartum depressive symptoms.The results suggested that fatalistic time perspective mediated the relationship between hair cortisol concentration in the first trimester and postpartum depressive symptoms. In other words, women with lower hair cortisol concentration in the first trimester were more likely to develop postpartum depressive symptoms, and this relationship was explained by fatalistic time perspective.

The results of our study indicate that women with very low hair cortisol concentration in the first trimester are at greater risk for postpartum depression. These are the first data to show that low level of cortisol in the first trimester can be a predictor of maternal postpartum depressive symptoms. The results of our study suggest that examining hair samples in the first trimester of pregnancy may be a valuable method for identifying women at risk of developing postpartum depression.

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The therapeutic alliance (TA) is increasingly acknowledged as a fundamental quality of care indicator. Numerous guidelines advocate TA awareness in practice, but lack specifics on building a strong TA. Yet, previous studies have found independent associations between levels of self-esteem, the quality of TA and severity of clinical symptoms in people with schizophrenia and other psychotic disorders. It suggests that the TA possibly mediates the relationship between self-esteem and psychotic symptoms. The present study therefore examined the relationships between these three factors in people with psychotic disorders.

Investigating the mediating effect of TA on the relationship between self-esteem and psychotic symptom severity.

The short forms of the Self-Esteem Rating Scale and the Working Alliance Inventory, respectively, were used to assess self-esteem and TA. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale. Linear regression models were applied, followed by a mediation-model when appropriate.

A higher self-esteem significantly predicted less severe psychotic symptoms (B = -.312; β = -.46, p <.001) and better TA (B = .123, β = .255, p = .009). There was no significant relation between TA and psychotic symptom severity (B = -.161; β = -0.109, p = .289), therefore no mediation-analysis was performed.

We found no association between TA and psychotic symptoms, which may be explained by the mild psychotic symptoms and overall high satisfaction scores on TA in our chronic sample. Another factor might be that current measurements assume a one-on-one relationship between a client and a professional, while nowadays multiple professionals are involved. We recommend re-evaluating the definition and assessment of the TA within chronic psychiatric populations. Our study results also offer practical guidelines for clinicians to improve their quality of care, such as the recommendation to focus on enhancing self-esteem in people with psychosis.

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In recent years, there has been an increase in alcohol consumption among women. Given that a significant percentage (1 in 3) of pregnancies are unplanned, fetal exposure to alcohol is inevitable in some.

The main objective of this work is to present a review of the current state of the art regarding the impact of alcohol use during pregnancy.

Evidence-based review, using a search on PubMed and selection of the most relevant studies on this topic, published in the last decade.

Although the international consensus recommends total abstinence from alcohol consumption during pregnancy, its global prevalence is 9,8%, with the highest percentage found in Europe (25,2%), which constitutes an important public health problem. Contrary to expectations, a recent study highlights that women who continue to consume alcohol during pregnancy were more likely to be older and have a higher socioeconomic status and educational level. Alcohol consumption during pregnancy is associated with high rates of maternal and child morbidity and mortality, with serious social, personal and family consequences. Prenatal alcohol exposure is the leading preventable cause of birth defects and neurodevelopmental disorders. The psychopharmacological treatment of alcohol use disorder during pregnancy is a challenge, given the limited evidence.

The main guidelines recommend total alcohol abstinence as no safe amount to consume has been identified. Stopping alcohol consumption during pregnancy is the only effective way to eliminate the risk of complications associated with this substance. A focus on early prevention and identification is essential, as well as, when necessary, referral for specialized treatment.

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Psychiatric assessment of psychotic disorders has traditionally relied on categorical classification systems, but there is a shift towards a dimensional approach in DSM-5 and ICD-11. Schizophrenia is increasingly viewed as a spectrum disorder, with genetic studies indicating shared risk factors among schizophrenia, schizoaffective disorder, and bipolar disorder. However, there is currently no widely used transdiagnostic dimensional assessment tool in clinical practice. At Semmelweis University we have developed a scale which takes into account four major symptom groups (catatonia, affective-, positive and negative symptoms) and several important “specifiers” (disorganisation, bipolarity, prodromal symptoms, childhood onset, etc.). Clinicians should assess their patients with CPAN based on the long-term clinical presentation, contrary to PANSS and other cross-sectional tools, since our theory is that long-term traits represent underlying “biology” in a more precise manner than the rapidly changing status of patients, and therefore should show higher correlation with biomarkers like genetic and imaging data.

We aimed to test the clinical usability of CPAN and its alignment with DSM-5 diagnostic categories and medication correlations in outpatient settings. Additionally, we planned a validation process to assess the tool’s validity, interrater reliability, and test-retest reliability.

In our pilot study, six clinicians assessed 104 outpatient patients using CPAN, analyzing DSM-5 diagnoses and medications. Patients were clustered into four groups based on leading symptoms. In the validation study, 100 inpatients with severe psychotic symptoms will be assessed three times by two raters—one from the clinical team and one independent. We will compare CPAN’s validity to PANSS results and assess test-retest reliability with three assessments.

The pilot study demonstrated that CPAN is user-friendly, taking 1-2 minutes for familiar clinicians to complete. Four symptom clusters were identified: 1) schizophrenia with catatonic symptoms, 2) schizophrenia without catatonic symptoms, 3) schizoaffective disorder with negative symptoms, and 4) schizoaffective disorder without negative symptoms/bipolar disorder. Prescription patterns were correlated with symptom groups, but detailed analysis was limited due to the small sample size. Validation results are pending.

CPAN is a practical tool for assessing long-term symptom presentation in patients with psychotic disorders. Widespread use of this scale could provide valuable real-life data linking symptoms to medication use and clinical outcomes. The ongoing validation study will further establish the scale’s validity and reliability

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The treatment landscape for mental health has transformed significantly with the emergence of digital platforms, which offer a promising public health solution by expanding access to mental health services. Despite their potential, further research is needed to evaluate both the usability and clinical effectiveness of these online interventions.

To investigate the usage patterns of an online mental health app and the effectiveness of chat-based emotional support (ES) in reducing psychological distress and achieving therapeutic goals.

The analysis included data from 3,751 users of ifeel app onboarded in 2023, 58% of whom were female and 42% male. Two main modalities were studied: chat-based therapy,( N= 3,170) and video therapy,( N=1,942), with some overlap as users could engage in both modalities. Key metrics for analysis included session frequency, session timing, session duration, and user demographics. The study also explored chat-based ES therapy by evaluating 113 individuals at two points in time: after one week of therapy, and after three weeks. Psychological distress levels were measured using the Kessler Psychological Distress Scale (K6), and goal attainment was measured through self-reports over the two time points.

Usage data showed a strong preference for chat-based therapy, with 85% of users engaging in chat therapy compared to 52% who used video therapy. Younger users, particularly those aged 25-34, were the most active in engaging with chat-based therapy. On average, chat therapy users send between 14 to 17 messages per month, whereas video therapy users take 2 sessions per month. These results underscore the higher frequency of engagement in chat therapy, particularly among younger demographics. In terms of clinical effectiveness, psychological distress was reduced significantly at both one week and three weeks of therapy. After one week of treatment, participants showed a significant reduction in distress symptoms (F(1) = 5.10, p = .03*) this was evident also after three weeks (F(1) = 24.25, p = .000***). Goal attainment showed substantial progress over time, with significant improvements in both groups (F(1) = 5.03, p = .03*; F(1) = 31.61, p = .000*), indicating that users were making meaningful strides toward their therapeutic goals.

This study underscores the usage pattern and clear preference for chat-based therapy, particularly among younger users. Chat-based emotional support therapy was found effective in reducing psychological distress, suggesting that online platforms, especially those offering chat-based therapy, are both accessible and clinically effective. Further research should focus on refining these services to maximize clinical outcomes, adapt to diverse user demographics, and ensure long-term engagement.

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Achieving excellent sport performance is based both on physical strength and mental endurance. Research demonstrated that children experiencing early maltreatment and traumatization are at an increased risk of high-risk behaviours, bullying, and mental and somatic disorders lasting into adulthood effecting academic and sport performance, relations and life management. Research found that individuals with a history of trauma had a significantly lower chance of being diagnosed with depression or anxiety if they had participated in team sports as adolescents. Also later in life, sport is very beneficial to cope with stressful life events.

We aimed to explore occurrence of early traumas in elite athletes and a control group using the Childhood Trauma Questionnaire (CTQ) and the Early Trauma Inventory Self Report-Short Form (ETISR-SF).

The sample included 57 subjects, 50.9% elite athletes and 49.1% leisure time athletes (controls). Participants (64.9% males, 35.1% females) provided demographic data (age 18-58 years, mean age = 31.96 years, SD = 8.920) and completed the ETISR-SF and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Analysis of Fisher’s Exact Test was performed for evaluating the occurrence of early traumatization.

The ETISR-SF and CTQ subscales scales did not show significant difference in any type of traumas in elite athletes compared to the control group (general traumas p=0.092, emotional abuse p=1.000, physical abuse p=0.592, sexual abuse p=0.297). Occurrence of each trauma type in the two groups were as follows. Elite athletes: sexual trauma (10.34%), physical trauma (55.17%), emotional trauma (44.83%), general trauma (55.17%); Controls: sexual trauma (21.43%), physical trauma (64.29%), emotional trauma (46.43%), general traumas (78.57%).

The occurrence of different type of trauma in our sample is in line with the literature. Physical and emotional abuse among athletes is high. Presumably, those athletes perform better who experience less trauma. The best way to produce resilient athletes is to provide a challenging and supportive sport environment, where athletes feel physically and psychologically safe in their experiences of success and failure.

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Jonathan will present the impacts of smoking on physical and mental health, the impact of smoking cessation on mental health and the need to reduce doses of some psychotropic medications after cessation in order to prevent toxicity. He will set out the low population coverage of evidence-based interventions for smoking cessation and prevention uptake particularly for people with mental health conditions, and the reasons for this. He will then outline implementable opportunities to scale up coordinated coverage of interventions by different sectors

None Declared

Work-related stress significantly impacts employees’ overall health and can lead to unhealthy lifestyle behaviors, such as poor diet, lack of physical activity, and inadequate sleep.

This study aimed to explore the potential link between occupational stress and different lifestyle behaviors among workers in different companies in Sousse, Tunisia.

A cross-sectional study was conducted over a three-year period in Sousse, Tunisia, involving employees from various workplace settings. Data were collected using a pre-established questionnaire that assessed sociodemographic characteristics, health-related behaviors—including sleep quantity and quality, cigarette smoking, alcohol consumption, physical activity (measured with the Global Physical Activity Questionnaire), and eating habits—as well as occupational characteristics. Occupational stress was evaluated using a validated Arabic version of the Karasek scale. Binary logistic regression was employed to calculate adjusted odds ratios with 95% confidence intervals.

The study included 154 participants, predominantly female (56.5%), with a mean age of 39.99 ± 9.91 years. Approximately 34.6% had 11 to 20 years of seniority. Job strain and iso-strain were reported by 31.8% and 25.5% of workers, respectively. Job strain prevalence was observed in 32% of smokers, 41% of alcohol users, 40 % among those who do not meet the recommended levels of physical activity. In terms of sleep quality, 29.9% indicated poor sleep. Notably, our study revealed a significant association between job strain and good sleep quality (aOR=6.14; CI95%:1.72-21.95, p=0.005).

These findings highlight a concerning prevalence of unhealthy lifestyle behaviors among workers in Sousse, Tunisia, with significant associations between occupational stress and sleep quality. Addressing these issues through workplace wellness programs may enhance employee health and overall job satisfaction.

None Declared

The detection of electrophysiological markers to differentiate patients with suicide attempts could support the efforts of clinicians to provide proper diagnosis and treatment for them, and finally reduce the suicide mortality rate.

The objective of the current study was to investigate and compare cortical functional networks from resting-state electroencephalogram in patients with suicide attempts and suicidal ideation using source-level weighted network analysis. We also examined the possibility of network features serving as biomarkers by differentiation between suicide attempts and suicidal ideation using machine learning techniques.

This study investigated source-level cortical functional networks using resting-state electroencephalography in drug-naïve depressed patients with suicide attempt and suicidal ideation. Electroencephalogram was recorded in 55 patients with suicide attempts and in 54 patients with suicidal ideation. Graph-theory-based source-level weighted functional networks were assessed using strength, clustering coefficient (CC), and path length (PL) in seven frequency bands. Finally, we applied machine learning to differentiate between the two groups using source-level network features.

There were significant differences in the three global level indices of the high alpha band. The strength and CC of the high alpha band were significantly lower in patients with suicide attempts than in those with suicide attempts ideation. In contrast, the PL of the high alpha band was significantly higher in patients with suicide attempts than in those with suicide ideation. No significant differences in the other frequency bands were between the two groups.

The nodal CCs of patients with suicide attempts were significantly lower than those of patients with suicide ideation in most regions, except for three of the 68 regions.

The best classification performance between suicide attempts and suicide ideation was an accuracy of 73.39%, a sensitivity of 76.36%, and a specificity of 70.37% with 17 features. Three of these features were global-level network indices (strength, CC, and PL) in the high alpha band; the other 14 features were high alpha band nodal level CCs in limbic, frontal, temporal, parietal,and occipital area.

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This is the first study to use electroencephalogram source level network measures, revealing that network indices for high alpha band could be potential biomarkers to distinguish betweensuicide attempts and suicide ideation in patients with depression. Moreover, our study evaluated the electroencephalogram signals immediately after fatal suicide attempts in a relatively large number of un-medicated patients.

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While most individuals adhere to preventive measures during pandemics, a subset engages in behaviors that may intentionally spread COVID-19, presenting unique challenges to public health efforts.

This study explores the psychological, social, and environmental factors influencing deliberate virus-spreading behavior in the Saudi Arabian population during the initial phase of the COVID-19 pandemic.

A cross-sectional online survey was conducted between April 3 and May 5, 2020, with 1,817 participants. The survey collected demographic information and variables related to virus-spreading inclinations. Descriptive statistics and Pearson’s chi-squared tests were used to analyze associations between deliberate virus-spreading behavior and various characteristics, with statistical significance set at p < 0.05.

Individuals who intentionally spread the virus (2% of the sample) were younger (mean age 22.9 vs. 29.3 years, p < 0.001), predominantly female (81.1% vs. 65.6%, p = 0.033), and more likely to have a history of mental health issues (24.3% vs. 8.5%, p < 0.001) and conspiracy beliefs (45.9% vs. 26.2%, p = 0.003) compared to those who did not engage in virus-spreading behaviors. No significant differences were found regarding marital status, education level, or traumatic life events.

This study highlights key factors associated with intentional virus-spreading behaviors, such as younger age, mental health history, and conspiracy beliefs, underscoring the need for integrated mental health support and targeted misinformation interventions. Public health strategies should include age-appropriate messaging and digital outreach to mitigate the risks posed by intentional spread behaviors and enhance pandemic response efforts. Further research with larger, more diverse samples is recommended to expand understanding and improve intervention strategies

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When an adolescent or young adult is diagnosed with cancer, they’re frequently accompanied by their caregiver. Literature shows that caregivers of adolescents and young adult cancer survivors (AYACS) frequently experience high anxiety and depressive symptoms. Being these caregivers an important source of support to AYACS during this challenging journey, one question emerges: does caregivers’ mental health impact AYACS’ quality of life (QoL)?

Considering this, this study examined the associations between caregivers’ mental health and AYACS’ QoL.

Forty-eight dyads were recruited in four hospitals and one association in Portugal. AYACS were mostly women (62.5%) and off-treatment (62.5%). They were, on average, diagnosed at 18.9 years (range: 15-25) and currently 21.98 (range: 15-38). Their caregivers were mostly women (77.1%) and, on average, 47.02 years (range: 19-76). Parent-child dyads were the most frequent. The Quality of Life Questionnaire Core-30 assessed the AYACS’ QoL. Caregivers’ mental health, the Hospital Anxiety and Depression Scale, and the FCR7 scale assessed caregivers’ anxiety and depressive symptoms and fear of cancer recurrence, respectively.

Preliminary results show that among AYACS’ QoL, only low social functioning was significantly related to high anxiety and depression in caregivers. Treatment status was also significantly positively related to AYAs’ social functioning and negatively to caregivers’ anxiety and depression. AYAs and caregivers’ ages at recruitment were also negatively correlated with caregivers’ anxiety. Age of AYACS at diagnosis, living with caregiver, and type of caregiver were not related to AYACS social functioning nor caregiver anxiety and depression. A model was tested, showing that caregivers’ anxiety and depression predict AYAs’ social functioning, having treatment status as covariable.

Caregivers’ mental health and treatment status were shown to be important for AYACS’ QoL, especially social functioning. This supports the need to assess how caregivers are adapting to this new stage of life and provide specialized support when needed. This could indirectly have a positive impact on the QoL of AYACS. It’s important that the support provided considers the diverse challenges these caregivers face, which can differ from other caregiver groups.

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